Nafarelin (Systemic)

Brand Names : Synarel

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For nafarelin, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to nafarelin or to gonadotropin-releasing hormone-like medicines. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Nafarelin use is not recommended during pregnancy. Nafarelin has not been studied in pregnant women. It has been shown to cause problems in animals, such as low birth weights and a slight decrease in the number of successful pregnancies.

For treatment of endometriosis - Stop taking this medicine immediately and check with your doctor if you suspect that you may have become pregnant .

Breast-feeding - It is not known whether nafarelin passes into the breast milk. However, use of nafarelin is not recommended during breast-feeding because it may cause unwanted effects in nursing babies.

Children - Studies of this medicine for treatment of endometriosis have been done only in adult patients, and there is no specific information comparing use of nafarelin to treat this condition in children younger than 18 years of age with use in other age groups. Endometriosis is not likely to occur before puberty.

When used to treat a child for central precocious puberty, nafarelin will stop having an effect soon after the child stops using it, and puberty will advance normally. It is not known if nafarelin causes:

• Changes in boys" and girls" future abilities to have babies after having used nafarelin around the time of puberty. Their chances of having children later are thought to be normal.
• Problems in the ovaries, such as cysts or a larger than normal ovary. Nafarelin stimulates the ovaries in adult women and has caused these problems in the ovary. It is not known whether nafarelin can also have these effects in younger girls treated for central precocious puberty.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking nafarelin, it is especially important that your health care professional know if you are taking the following:

• Nasal decongestant sprays - It is not known whether nasal decongestant sprays can decrease the amount of nafarelin that enters the bloodstream through the lining of the nose. For this reason, you should wait at least 2 hours after using nafarelin before you use a nasal decongestant spray

Other medical problems - The presence of other medical problems may affect the use of nafarelin. Make sure you tell your doctor if you have any other medical problems, especially:

• Bleeding from the vagina (abnormal or of unknown cause) - For adult women treated for endometriosis or girls treated for central precocious puberty, using nafarelin when the reason for vaginal bleeding is not known may make it harder for the doctor to find the cause of the problem, and may cause a delay in treatment of the condition
• Other conditions that increase the chances of developing thinning bones or osteoporosis (brittle bones) - If you are an adult female being treated for endometriosis, it is important that your doctor know if you already have an increased risk of osteoporosis. Some things that can increase your risk for having osteoporosis include cigarette smoking, alcohol abuse, and a family history of osteoporosis or easily broken bones. Some medicines, such as corticosteroids (cortisone-like medicines) or anticonvulsants (seizure medicine), can also cause thinning of the bones when used for a long time